Family Centered Care and Pain Flashcards
Family
A group of individuals who share a legal or genetic bond, but for many it means much more
Legal bond
A family thats legally bound through marriage, adoption, guardians, and includes the rights, duties, obligations, and contracts that they entered in to
Can be changed, expanded or dissolved
Blood bonds
individuals who are directly related through a common ancestor
Close and distant realtives
Types of family
Nuclear or Conjugal Extended Complex Step Traditional Adopted Foster
Nuclear or Conjugal family
Parents and their children living in the same residence or sharing the closest of bonds
Extended
Includes all relatives being in close proximity (generations: X, Y, Z) where relatives live maybe not next door to each other, but in the same city
Household that is extended: these families can live together and share household duties, also called joint family or multigenerational family depending on which member are included
Complex
Extended family which has 3 or more adults + their children
Formed through divorce and remarriage or may be formed through polygamy in societies where that practice is acceptable
Families may be complex without formal legal binds between adults
Step
Families where adults have divorced and remarried bringing children from other unions together to form a new nuclear family
Called blended family
May come from several different parents or may be new to the family
Traditional
Classical family
Father works outside of the household to support the members financially while the mom stays at home and raises the children and takes care of them
Roles may be reversed
Adopted
Family shares legal bond but not genetics
Can be emotional or spiritual bond where no formal legal bonds are present
Foster
Includes one or more adult parents who serve as temporary guardians for one or more children to whom they may or may not be biologically related to
More formal arrangements may be made
Foster children can be legally adopted
Enabling
When we can enable a family through education and practice to acquire the competencies they require to take care of their child, they are able to meet the needs of their family
Empowerment
Returns to the family a sense of control
This is something we can give to the family– a sense of control that they had lost when their child got sick
Family Centered Care Basic concepts:
Enabling
Empowering
Control
Communication
Communication
When we communicate, we offer education, we foster and honor the families sense of strength, abilities, and action
The family that will be taking care of the child upon discharge
Its imperative that we give them these skills, knowledge, and encouragement
Promoting Healthy Families
Disease prevention
Health promotion
The family is the driver
Family Centered Care: Best approaches
Education
Anticipatory Guidance
Education
Important that we helpguide families through the stages of child growth and development and milestones of each age
If we identify problems early we can get better outcomes
Anticipatory Guidance
Help the family understand the medical treatment and diagnosis
Encouraging the children to ask questions about their bodies and conditions, referring families appropriately to agencies or support groups
ABOVE ALL COMMUNICATE!
Parenting Styles
Authoritarian
Authoritative
Permissive/Indulging
Uninvolved
Parenting Styles: Authoritarian
Children are expected to follow very strict rules established by the parent and a failure to follow these rules will result in punishment
“Because I said so” parents
Often fails parents because they aren’t giving reasoning to. children about the action, so the children don’t understand why they are doing what they are doing
Parents have very high demands, children are not responsive
Children are obedient and proficient but often in test show lower confidence/self-esteem, happiness, and social competence than other children
Parenting Styles: Authoritative
Like Authoritarian, having guidelines that they expect their children to follow, however they are more democratic
Responsive to their children and are willing to listen to their questions
More nurturing and when their children fail, they often are more forgiving and don’t give heavy/strict punishment
Assertive but not restrictive or intrusive
Disciplinary methods aren’t necessarily punitive
Desire their children to be assertive, socially responsible, and cooperative
Children are usually very happy, capable, and successful in their lives
Parenting Styles: Permissive/Indulging
Parents make very few demands of their children
Rarely discipline children
Have low expectations of maturity and self-control
Non-traditional parents and are very lenient
Will avoid confrontation
Can be nurturing and communicative, but they are more like a friend and not a parent
Almost like they are living through their children
Children rank low in happiness and self-regulation, have problems with authority and perform poorly in school
Parenting Styles: Uninvolved
Parent place very few demands on children
Not alot of responsiveness and there is little communication
Fulfill the child’s basic needs, but are detached
Extreme cases: they may reject or neglect their child’s needs
Children lack self control, low self-esteem, and are less competent than their peers
Parenting influences
Key characteristics parents should always exhibit when working with their children
Engagement
Consistency
Validation
Engagement
Need to be engaged
Invested in childs activities
Spending quality time with child
Consistency
Must be consistent in what they do with children
Cant deviate
Children need consistency, so that they know what it is that they are expected to do and can do
Validation
Builds self-esteem
Validate: feelings (even if they seem inconsequential or idiotic), fears (its ok to be scared but you will work through the fear), and all other emotions
Children see thing differently
Parental Guildlines
Safety
Realistic expectations
Discipline
Pediatric choices
Safety
Most important to address with parents
Realistic expectations
of their children and self
Discipline
how to incorporate into family setting, knowing when its appropriate to use it
Focus on the importance of consistency
Focus on positive reinforcement and NOT negative reinforcement
Pediatric choices
Parents need to be careful what they offer the child
These influences can be tremendous
Children that spend alot of time with their parents are directly influenced by their behaviors, choices, and beliefs
Family Stressors
A sick child could be the first crisis that the family faces
Depended on: Severity of illness, Frequent flyer, Medical procedures, coping abilities, cultural/religious beliefs
Frequent flyer
Do they have previous experience with illness/hospitalization?
Sometimes they know what to expect, it can be a stressor because if something different happens, then they know disease has progressed
Coping abilities
What are their personal strengths?
Family support system?
Other stressors are on the family system?
Common themes in families with hospitalized children
Families become helpless, they question the skills of the staff, they don’t understand/hear because they are stressed (you must reinforce teachings, use simple explanations
They need their fears and uncertainty respected
They need reassurance
They need to see the staff being compassionate and concerned for their child, attending to every detail
Sibling response
Lives are turned upside down
Become scare, lonely, and angry
Start noticing their parents pay more attention to the sick child and become jealous and resent their sick sibling, then they feel guilty for the jealousy
Behavior often regresses to that of a previous developmental stage (its ok)
These children need someone to talk to them about their siblings situation because they are emotionally stressed out
Children and hospitalizations
Young children are vulnerable to stress and are so used to a routine and may not have the coping mechanisms necessary to deal with this new situation
Children and hospitalizations: Children’s Experience
Parental separation
Loss of control
They dont feel well and they dont understand why, and dont understand fear
